Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Otorhinolaryngol. Feb 28, 2016; 6(1): 1-12
Published online Feb 28, 2016. doi: 10.5319/wjo.v6.i1.1
It is 2015: What are the best diagnostic and treatment options for Ménière’s disease?
Safeer Shah, Abel Ignatius, Syed Ahsan
Safeer Shah, Abel Ignatius, Wayne State University School of Medicine, Detroit, MI 48201, United States
Syed Ahsan, Department of Otolaryngology/Head and Neck Surgery, Henry Ford Health System, Detroit, MI 48202, United States
Author contributions: Shah S was involved in the acquisition of information, drafting the article and final approval of the version of the article for submission; Ignatius A was involved in the acquisition of information, drafting of the article and approval of the final version for submission; Ahsan S was responsible for conception and design of the review, drafting the article, performing final editing and approval of the final version for submission.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Syed Ahsan, MD, FACS, Department of Otolaryngology/Head and Neck Surgery, Henry Ford Health System, 2799 W. Grand Blvd. K-8, Detroit, MI 48202, United States. sahsan3@hfhs.org
Telephone: +1-313-9167442
Received: July 22, 2015
Peer-review started: July 27, 2015
First decision: October 13, 2015
Revised: October 22, 2015
Accepted: December 7, 2015
Article in press: December 8, 2015
Published online: February 28, 2016
Abstract

Ménière’s disease (MD) is a common cause of recurrent vertigo. Its pathophysiology is still unclear and controversial. The most common histological finding in postmortem temporal bone studies of patients is endolymphatic hydrops (EH). However, not all cases of hydrops are associated with MD and it may represent the end point of various etiologies. The diagnostic criteria for MD have undergone changes during the past few decades. A recent collaboration among specialty societies in United States, Europe and Japan has given rise to a new set of guidelines for the diagnosis and classification of MD. The aim is to develop international consensus criteria for MD that would help improve the quality of data collected from patients. The diagnosis of MD can be difficult in some cases as there is no gold standard for testing. Previous use of audiometric data and electrocochleography are poorly sensitive as screening tools. Recently magnetic resonance imaging as a diagnostic tool for identifying EH has gained popularity in Asia and Europe. Vestibular evoked myogenic potentials are also used but lack specificity. Finally, the treatment for MD has improved with the introduction of intratympanic treatments with steroids and gentamicin as well as less invasive treatment with the Meniett device.

Keywords: Ménière’s disease, Review, Pathophysiology, Diagnosis, Treatment

Core tip: The pathophysiology of Ménière’s disease (MD) is still unclear and controversial. The most common histological finding in postmortem temporal bone studies of patients is endolymphatic hydrops. This finding is utilized in the newest method of diagnosis using magnetic resonance imaging with intratympanic or intravenous gadolinium. Changes to the diagnostic criteria have been proposed with collaboration from various international societies. This will help in communication and improve quality of published data. Finally, the use of intratympanic steroids and Meniett pressure treatments offers less invasive and destructive treatments for patients with MD.